Adult Dosing

Treatment of primary systemic carnitine deficiency

TABS

• Start 990 mg PO bid-tid

SOLN

• Start 1 g/day; titrate slowly
• Range 1–3 g/day PO in divided doses

• Administer alone with/without meals, or dissolve in drinks/other liquids to reduce taste fatigue
• Consume slowly and space doses evenly throughout the day to increase tolerance

Pediatric Dosing

Treatment of primary systemic carnitine deficiency

TABS

• Start 50 mg/kg/day; increase gradually, based on clinical response
• Range 50–100 mg/kg/day PO in divided doses
• Max 3 g/day

SOLN

• Start 50 mg/kg/day; titrate slowly, based on clinical response
• Range 50–100 mg/kg/day PO in divided doses
• Max 3 g/day

• Administer alone with/without meals, or dissolve in drinks/other liquids to reduce taste fatigue
• Consume slowly and space doses evenly throughout the day to increase tolerance

• Primary systemic carnitine deficiency
• Acute/Chronic treatment of patients with an inborn error of metabolism resulting in secondary carnitine deficiency

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• For oral administration only
• Rapid consumption of oral solution may lead to GI reactions; advise patients to consume slowly and space evenly throughout the day to maximize tolerance
• Chronic administration of high doses in patients with ESRD/severely compromised renal function may result in accumulation of the potentially toxic metabolites
• Oral Solution may be consumed alone or dissolved in drinks or other liquid foods to reduce taste fatigue
• Monitor blood chemistry, vital signs, plasma carnitine concentrations

Cautions: Use cautiously in

• Renal insufficiency
• Seizure disorders

Pregnancy Category:B

Breastfeeding: Safety unknown, use with caution. Any risks to the child due to excess carnitine intake should be weighed against the benefits of supplementation to the mother. Manufacturer recommends discontinuation of breastfeeding, or postponing of treatment (based on risk benefit assessment)

• GI: Nausea, vomiting, abdominal cramps, diarrhea
• CNS: Seizures
• MUSC: Mild myasthenia (uremic patients)
• MISC: Body odor

• Vitamin/Nutritionals: Participates in energy metabolism by transporting long chain fatty acids across the mitochondrial membrane; it also exports acyl groups from subcellular organelles and from cells to urine before they accumulate to toxic concentrations. It is handled by several proteins in different pathways including carnitine transporters, carnitine translocases, carnitine acetyltransferases and carnitine palmitoyltransferases
• Absolute bioavailability: 15%
• Metabolized by liver to trimethylamine N-oxide and [3H]-gamma-butyrobetaine; CYP450: unknown
• Renally excreted: 4-8% unchanged; feces: <1 %
• Half-life: 17.4 hrs

US Trade Name(s)

• Carnitor
• Carnitor SF

US Availability

levocarnitine (generic)

• TABS: 330 mg
• SOLN: 1 g/10mL

Carnitor

• TABS: 330 mg
• SOLN: 1 g/10mL

Carnitor SF

• SOLN: 1 g/10mL

Canadian Trade Name(s)

• Carnitor

Canadian Availability

Carnitor

• TABS: 330 mg
• LIQU: 100 mg/mL

UK Trade Name(s)

• Carnitor

UK Availability

Carnitor

• SOLN: 100 mg/mL
• SOLN: 300 mg/mL

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Nutrition/Electrolytes

Oral Nutritional Supplements

Pricing data from www.DrugStore.com in U.S.A.

• Carnitor 330 MG TABS [Bottle] (SIGMA-TAU)
  90 mg = $84.99
  180 mg = $161.69
• Levocarnitine 1 GM/10ML SOLN [Bottle] (RISING PHARMACEUTICALS)
  118 10ml = $31.99
  354 10ml = $87.97
• Carnitor 1 GM/10ML SOLN [Bottle] (SIGMA-TAU)
  118 10ml = $39.99
  354 10ml = $102.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Carnitor (LEVOCARNITINE 330 mg) (Sigma-Tau Pharmaceuticals, Inc.)
• Levocarnitine 330 MG Oral Tablet (Hi-Tech Pharmacal Co., Inc.)
• Levocarnitine 330 MG Oral Tablet (Rising Pharmaceuticals Inc)